Return to APAP with P30i mask many CA

[OpalRose]

Ok, post again tomorrow, especially if you see any changes.

[Roy289]

Increasing the time wearing the P30i. AHI 5.52

Last night 5h 15min  which is record for me.  Mask leakage (actually exhaling  some air from my mouth) still a major issue.  Back to CA's(27)  dominating the events.  I sleep on my right side most of the night.

   

I usually start out sleep on my back and then turn onto my right side.  There is a cluster of CA during the beginning of the second session while on by back (no mask leakage during this interval).


   

[OpalRose]

Flow Limitation is causing the pressure to rise, and the CA's are about the same.

Your median pressure is around 10, so I'm thinking to raise your minimum pressure to 9cm and the EPR back to 2. This should help with FL's and Hypopneas.

Know that the Apap cannot treat CA's, but they may lessen over time.

[Roy289]

Opalrose

Made the changes you suggested last night.  Only wore mask for 2h 24m with AHI 1.67.  Unfortunately aerophagia was so bad I had to take mask off.

During the session I wasn't sleeping very often based on flow rate.  I'll continue with the settings unless you think adjustments should be made.

   

[Roy289]

Break through on reducing mask leakage

I tried changing the P30i pillows to Large instead of Medium.  This step drastically reduced the leakage although still having "open mouth issues". 

Still unable to wear mask any length of time due to mouth filling with air.  I tried taping my mouth but this resulting in "chipmunk cheeks" and only way out was to swallow the air which produces aerophagia.  Working on sealing tongue but still a "work in progress".

   

[Roy289]

Just recovering from a heart attack on Oct 17.  They found 90% occlusion on my left main artery.  Had DES stent inserted on Oct 19 and discharged from hospital on Wed Oct 21.

Thought I'd try CPAP again as still quite tired during afternoons.  Below are two nights  Oct 27/28 which show Cheyne-Stokes.  I think this happens when I'm sleeping on my side.

Do you think I should continue on CPAP or give it a break until after seeing my cardiologist on Nov 26?


   
   

[OpalRose]

Sorry to hear about the heart attack.  When you see your Cardiologist, talk to him about the Cheyenne stokes and Clear Airways.  Print out a copy of your graphs for him to review.  

I'm not a Doctor, so take any advice here as such.  I'm sure you've been sent home with medications to take and sometimes that can cause Clear Airways.  

I would just like to see you more comfortable until you discuss all this with your doctor.  You also suffer from Aerophagia (swallowing of air), so I'm going to suggest you switch to Cpap mode with a pressure of 10cm.  Also, you have a history of  Clear Airways, so set the EPR to 1.

You may have a few more apnea's, but you should be more comfortable.  Give it a couple days and post another chart.

Good luck, take time to heal.

[Roy289]

OpalRose,

Thanks very much for the suggestions. The DES stents do require medication to reduce platelet clumping along with ASA 81mg for a year. The meds may have an affect on CA's.

I'll try using CPAP mode at 10 and EPR-1 as suggested. Post to follow